Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.19 / $8.66 / $21.98	Facility	26	$6.19	$8.66	$21.98
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.57 / $168.26 / $333.70	Facility	TC	$25.57	$168.26	$333.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.43 / $29.69 / $62.27	Professional		$17.43	$29.69	$62.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.53 / $8.13 / $19.32	Professional	26	$5.53	$8.13	$19.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.57 / $24.10 / $44.28	Professional	TC	$19.57	$24.10	$44.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.45 / $22.87 / $52.18	Professional		$21.45	$22.87	$52.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.80 / $6.25 / $10.52	Professional	26	$4.80	$6.25	$10.52
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.92 / $20.48 / $31.12	Professional	TC	$17.92	$20.48	$31.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.31 / $28.55 / $47.09	Professional		$22.31	$28.55	$47.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.65 / $8.07 / $14.82	Professional	26	$6.65	$8.07	$14.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.31 / $19.89 / $33.04	Professional	TC	$15.31	$19.89	$33.04
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $30.79 / $30.79 / $30.79	Professional		$30.79	$30.79	$30.79
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $7.09 / $7.09 / $7.09	Professional	26	$7.09	$7.09	$7.09
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $23.69 / $23.69 / $23.69	Professional	TC	$23.69	$23.69	$23.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6.61 / $25.18 / $36.53	Professional		$6.61	$25.18	$36.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.31 / $7.31 / $7.80	Facility	26	$7.31	$7.31	$7.80
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $24.00 / $25.73 / $25.73	Facility	TC	$24.00	$25.73	$25.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.39 / $35.56 / $63.87	Professional		$23.39	$35.56	$63.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.58 / $8.42 / $14.19	Professional	26	$5.58	$8.42	$14.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.10 / $27.25 / $48.29	Professional	TC	$18.10	$27.25	$48.29
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $7.31 / $7.31 / $7.80	Facility	26	$7.31	$7.31	$7.80
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $24.00 / $24.00 / $25.73	Facility	TC	$24.00	$24.00	$25.73
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $24.06 / $35.32 / $63.87	Professional		$24.06	$35.32	$63.87
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $6.08 / $9.02 / $17.12	Professional	26	$6.08	$9.02	$17.12
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $18.87 / $27.28 / $46.18	Professional	TC	$18.87	$27.28	$46.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.52 / $36.24 / $51.07	Professional		$26.52	$36.24	$51.07
United Facility/Professional Professional Modifier Low / Median / High Price $21.78 / $30.67 / $54.17	Professional		$21.78	$30.67	$54.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.36 / $7.57 / $13.14	Professional	26	$5.36	$7.57	$13.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.42 / $23.00 / $41.14	Professional	TC	$16.42	$23.00	$41.14